Osteochondrosis is a widespread disease of the spine that affects the intervertebral discs and cartilage. The cervical and lumbar regions are more susceptible to such processes. Osteochondrosis of the lumbar region can cause constant pain in the lower back and significantly complicate a person's life. In the treatment of the disease, conservative methods are preferred, surgical intervention is resorted to only in extreme cases.
Causes of lumbar osteochondrosis
Osteochondrosis is not so much a disease as a frequent natural phenomenon that occurs as a result of age-related degenerative changes in the spine. Normally, the disc in the lumbar spine acts as a shock absorber between two vertebrae and allows the joints and spine to move easily. The outer part of the disc, the annulus fibrosus, surrounds the soft inner core of the disc, the nucleus pulposus. Everyone's spinal discs undergo degenerative changes with age, but not everyone develops symptoms.
Osteochondrosis is believed to begin with changes in the annulus fibrosus, intervertebral disc, and subchondral bone. The annulus fibrosus loses water, making it less able to withstand the daily stresses of the spine by misdistributing them. Overloading the back of the vertebrae leads to arthritis of the facet joints and hypertrophy (growth, with the formation of osteophytes - bone growths) of the vertebral bodies adjacent to the affected disc.
Reference! According to statistics, 30% of people between the ages of 30 and 50 have some degree of spinal disc degeneration.
There are two main pathophysiological causes of pain in lumbar osteochondrosis. One possible cause of pain is inflammation of the nerves as a result of the outer part of the disc tearing and the inner core leaking out. Inflammatory proteins are released that irritate nerve tissue.
According to the second reason, the vertebrae, due to age-related deformation, are no longer able to effectively take the load. This causes the spine to move abnormally and causes a painful spasm of the back muscles that try to stabilize the spine.
The result of osteochondrosis can be the destruction of segments of the spine, which leads to radiculitis. Risk factors that trigger and accelerate degenerative processes in the spine are:
- Hereditary predisposition to diseases of the musculoskeletal system;
- smoking;
- Previous injuries;
- Hormonal and vascular disorders;
- Excess body weight;
- Muscles that are too weak and do not provide the necessary support for the spine;
- Professional activities related to heavy physical labor (athletes, loaders).
Stages of development of lumbar osteochondrosis
Disorders in the intervertebral discs, leading to their degeneration and destruction, occur gradually. The entire pathological process goes through several stages, according to which the stages (or degrees) of lumbar osteochondrosis are distinguished:
- The first stage (degree) is characterized by mild symptoms. Painful sensations develop against the background of irritation of the nerve endings from the nucleus pulposus penetrating into the fissures of the fibrous ring.
- The second stage is characterized by displacement of the upper vertebra relative to the lower one, due to cracking of the core and annulus. These pathological processes, in addition to pain during movement, cause the appearance of neurological symptoms, a feeling of numbness and instability of the affected area.
- The third stage is characterized by an increase in pain and the appearance of herniation of the intervertebral discs, due to a violation of the integrity of the fibrous ring. Pain, sensory impairment, and muscle weakness interfere with daily tasks. Due to pinched nerve roots, the functioning of the excretory and intestinal systems may be impaired.
- The fourth stage corresponds to the complete destruction of the intervertebral discs, they become fibrous, and the osteochondral growths of the vertebral bodies cause immobility of the spine in this department.
Symptoms of lumbar osteochondrosis
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- Neurologist
- Orthopedist
- A therapist
The main symptom of lumbar and sacral osteochondrosis is pain. It is usually aggravated by sitting for long periods of time or when turning, bending the spine, or lifting a load. The pain can radiate to the leg, groin and be accompanied by a feeling of numbness and weakness. Moderate, aching, dull pain may be followed by flare-ups.
The symptoms directly depend on the stage of development of the pathology:
- In the early period, when degenerative changes are just beginning to appear, symptoms are minimal.
- The intermediate stage, which is characterized by a weakening of the fibrous ring, can already manifest itself as pain in the lower back.
- At a later stage, when fibrosis develops in the structures and osteophytes are formed, the pain becomes less pronounced, but the mobility of the spine decreases significantly.
Lower back sensitivity may increase to touch. The characteristic shooting pains in the buttock, thighs and tingling sensation are a sign of pinched nerve roots that occur as a result of degenerative changes in the disc. Patients with lumbar osteochondrosis have difficulty bending forward, backward and sideways. Osteochondrosis can be complicated by disc herniation and narrowing of the spinal canal, accompanied by the appearance of additional symptoms.
Diagnosis of lumbar osteochondrosis
Making the diagnosis begins with the collection of anamnesis, questioning and examination of the patient. The specialist will be interested in your complaints, physical activity, presence of old injuries, bad habits and cases of illness in close relatives. During a physical exam, the doctor palpates (feels) the lower part of the spine, looking for tender areas, inflammation, or any abnormalities. He may also check sensation and perform motor tests.
The most popular method for diagnosing lumbar osteochondrosis is X-ray examination. The image will show the presence of osteophytes, narrowing of the joint space of the disc, or the so-called "vacuum" symptom, when gas bubbles are detected in the thickness of the disc. Other methods used are:
- MRI showing hydration (the degree of water saturation), the shape of the discs, their height, which allows identification of pinched nerves.
- CT scan, which allows you to examine the condition of tissues in detail and diagnose disorders in the earliest stages.
- Provocative discography used to determine the location of the affected disc.
Reference! MRI is a fairly accurate diagnostic method, but it cannot detect a tear in the outer rings of the disc.
Methods of treatment of lumbar osteochondrosis
The preferred treatment for lumbar degenerative disc disease associated with chronic pain is conservative treatment with physical therapy, exercise, and medication. For patients with lumbar osteochondrosis, it is recommended:
- A daily routine including sufficient rest and adequate physical activity;
- Regular physical exercises aimed at strengthening muscles;
- Lifestyle adjustments including nutritional review and weight loss.
Physiotherapy
Various physiotherapy techniques are successfully used to reduce low back pain. Physiotherapy promotes regenerative processes in the disc, stimulates metabolic and transport processes, prevents the formation of adhesions and further damage.
Physiotherapy methods used to treat spinal osteochondrosis include:
- Electrical stimulation. Electrical impulses help relieve back pain and improve blood circulation in the affected spine.
- Ultrasound therapy. Ultrasound waves can penetrate deep tissue layers and help relieve inflammation and pain.
- Magnetotherapy. Magnetic fields can improve blood circulation and metabolic processes in tissues, promoting their regeneration.
- Laser therapy. Laser beams can help relieve pain, stimulate blood circulation and stimulate tissue regeneration.
- Ultraphonophoresis. This method combines ultrasound therapy with the use of drugs that penetrate deep tissue layers and help relieve inflammation and pain.
important! Contrary to popular belief, osteochondrosis can and should be treated. Left untreated, it will become a source of chronic pain and can lead to a host of problems, including dysfunction of internal organs.
Medication treatment
To relieve pain that interferes with daily activities, patients are prescribed analgesics and nonsteroidal anti-inflammatory drugs. According to the indications, the doctor can prescribe stronger drugs: muscle relaxants, steroids and narcotic pain relievers. Therapeutic blocks are administered with local anesthetics and glucocorticoids to relieve intense pain.
surgery
Much less often, surgical intervention is used for osteochondrosis of the lumbar region. It may include disc arthroplasty or lumbar spine fusion (creating conditions for two vertebrae to fuse while pain is reduced by eliminating movement in that part of the spine).
If the movement of the spine is significantly impaired, special intervertebral spacers can be installed. In patients who do not respond to all other treatments, a total lumbar disc replacement may be performed.
Treatment of lumbar osteochondrosis at home
The most effective thing you can do at home to maintain functionality and control pain is to exercise. They will increase the flow of blood, oxygen and nutrients to the spine, helping to keep the cartilage hydrated and the spine flexible for as long as possible. In addition, endorphins are released during exercise, which are natural pain relievers.
Frequent change of posture also brings relief. Some positions help to cope with an attack of pain: kneeling, lying down, lying down. Short rest is necessary and useful, but prolonged lying only worsens the condition. It is important to stay active to prevent the disease from progressing. Patients with lumbar osteochondrosis benefit from walking, swimming, cycling, yoga, pilates, stretching exercises and strengthening the muscle corset. The following measures also help:
- Applying heat to the lower back improves circulation and relieves muscle spasms and tension.
- Ice packs will help relieve pain and reduce inflammation.
- Massage also relaxes muscles, relieves spasms and reduces pressure on the spine, thus relieving pain. By increasing blood circulation in this area, metabolic processes are improved and tissues are enriched with oxygen.
- Use of orthopedic mattresses and pillows. They will help maintain the correct position of the spine during sleep.
- Correct distribution of the load on the spine. When lifting heavy objects, you must use proper lifting technique to avoid straining the lumbar spine.
- Healthy diet. Eating a balanced diet rich in calcium and vitamins will help maintain healthy bones and joints.
However, if you have pain or other symptoms, before starting treatment for osteochondrosis at home, you should consult your doctor to get more accurate recommendations and assess the condition of the spine.
Which doctor should I see for lumbar osteochondrosis?
If symptoms characteristic of lumbar osteochondrosis appear, it is recommended to consult a neurologist or orthopedist. If you have lower back pain, you can also make an appointment with a therapist. He will order the necessary tests to establish the diagnosis and refer you to a specialist.
Treatment of lumbar osteochondrosis
Specialists from the nearest clinic in your city or other populated place are ready to understand the reasons and help to deal with the pain. Doctors usually have extensive clinical experience and master all modern methods of treatment and diagnosis of osteochondrosis in women and men. For the most part, the convenient location, excellent equipment and flexibility of the institutions are a priority of modern medicine, which allows you to quickly undergo any examination and restore the health of the musculoskeletal system. You can make an appointment by calling a clinic convenient for you, as well as on the website by filling out the online form.
Prevention of lumbar osteochondrosis
Effective methods of preventing lumbar osteochondrosis are:
- Regular physical activity. Keep in good physical shape. Strengthen your back muscles. Back stretching and strengthening exercises will help keep your spine healthy.
- Reduce stress on the spine: Avoid unnecessary stress on the spine. When lifting heavy objects, use proper lifting technique.
- Posture correction: ensure proper posture. Sit and stand straight, don't slouch. Choose an orthopedic pillow and sleeping mattress to maintain the correct position of the spine during rest. Buy quality shoes with good cushioning and support.
- Take care of the back support by using orthopedic chairs if due to the nature of your profession you are forced to sit for a long time. Avoid standing in one position for a long time. Take regular breaks and stretch your spine.
- Watch your weight. Being overweight can put extra stress on the spine.
- Avoid uncontrolled movements and back injuries. Be careful when doing sports or physical activity.
- Quit smoking, which can negatively affect spine health.
By following simple recommendations, you can live an active and fulfilling life, minimizing the risks of back pain. If you already have symptoms, pain in the lumbar spine, be sure to consult a doctor for diagnosis and treatment.